Common Questions
Why should I have health insurance?
Having health insurance is important because it helps protect you from high medical costs if you get sick or injured. It also gives you access to regular check-ups and preventive care to keep you healthy. With health insurance, you can see doctors and hospitals in your network at lower costs, saving you money in the long run. Health insurance also provides peace of mind, knowing you and your family are covered in case of unexpected health issues.
What are the best health insurance options available?
There are several good health insurance options, including plans from companies like Blue Cross Blue Shield, UnitedHealthcare, Ambetter, Oscar, and Medica. We can help you compare different plans based on what they cover, how much they cost, and which doctors and hospitals they include to find the best one for you.
How do I apply for health insurance?
You can apply for health insurance through the Health Insurance Marketplace at healthcare.gov, directly from insurance companies, or with the help of one of our very own health insurance agents. Private insurance options are also available outside the marketplace. Open enrollment happens once a year, but you can also apply if you have a big life change, like getting married or losing other insurance.
ACA (Obamacare)
Can I get financial help to pay for Obamacare?
Yes, you can get financial help through subsidies if your income is between 100% and 400% of the federal poverty level. These subsidies can lower your monthly premiums and out-of-pocket costs.
What if I miss the open enrollment period for Obamacare?
If you miss open enrollment, you might still get coverage if you qualify for a special enrollment period due to a major life event, like getting married, having a baby, or losing other health coverage. Additionally, you can consider short-term health insurance as a temporary solution until the next open enrollment period.
How do I find out which doctors and hospitals are covered by my Obamacare plan?
You can find out which doctors and hospitals are covered by reaching out to one of our agents. We can provide detailed information and directories of in-network providers, making it easy to see which healthcare providers are included in your Obamacare plan.
Short-Term
How long can I have short-term health insurance?
You can have short-term health insurance for up to 364 days and may renew it with limitations. However, renewal terms vary by insurer, so check with us for specific options.
What happens if I need care not covered by my short-term health insurance plan?
If you need care not covered by your short-term plan, you'll be responsible for the full cost of those services. It’s important to know the coverage limits and consider supplemental insurance if needed.
How do I find the best short-term health insurance plan?
To find the best short-term plan, compare options based on coverage, cost, and provider networks. We can help you navigate choices and find a plan that meets your temporary coverage needs.
Indemnity
How long does it take to receive benefits from hospital indemnity insurance?
Benefit payments are typically processed quickly once you submit a claim with the required documentation. The exact time frame varies, so check with your provider for specific details.
What should I consider when choosing a hospital indemnity insurance plan?
When selecting a plan, consider factors like daily benefit amounts, coverage limits, exclusions, and premium costs. We can help you compare different plans and find one that fits your needs.
How do I file a claim with my hospital indemnity insurance?
To file a claim, you’ll need proof of hospitalization, such as hospital records and bills. Contact your insurance provider or one of our pros for detailed instructions on the claims process and required documentation.
Advantage
Are prescription drugs covered by Medicare Advantage plans?
Many Medicare Advantage plans include prescription drug coverage (Part D). These plans are known as MAPD plans—check plan details to ensure your medications are covered.
Can I switch from Original Medicare to Medicare Advantage?
Yes, you can switch during the Annual Enrollment Period or if you qualify for a Special Enrollment Period. Contact us for help making the switch.
What should I consider when choosing a Medicare Advantage plan?
Consider factors like coverage benefits, provider networks, out-of-pocket costs, and prescription drug coverage. We can help compare plans to find the best fit for your healthcare needs and budget.
Medigap
Are prescription drugs covered by Medicare Supplement plans?
No, Medigap plans do not cover prescription drugs. You will need a separate Medicare Part D plan for prescription drug coverage.
Can I switch Medigap plans if my healthcare needs change?
Yes, you can switch Medigap plans anytime, but if you apply outside your Open Enrollment Period, medical underwriting may apply, affecting coverage and pricing.
What should I consider when choosing a Medicare Supplement plan?
Consider factors like coverage benefits, monthly premiums, and the insurer’s reputation. We can help compare plans to find the best fit for your needs and budget.
Prescriptions
Who is eligible for Medicare Part D?
You qualify for Medicare Part D if you are enrolled in Medicare Part A and/or Part B. You can sign up through private insurance companies that offer these plans.
What is the Medicare Part D “donut hole,” and how does it work?
The "donut hole" is a temporary limit on prescription drug coverage, where you may pay higher out-of-pocket costs. In 2025, Medicare will eliminate the "donut hole" and cap annual out-of-pocket drug costs at $2,000.
Can I switch Medicare Part D plans if my medication needs change?
Yes, you can switch plans during the Annual Enrollment Period (Oct 15 – Dec 7). You may also qualify for a Special Enrollment Period if you experience certain life events.
Dental & Vision
What services are covered by dental insurance?
Dental insurance typically covers preventive care (cleanings and exams), basic procedures (fillings), and major procedures (crowns and root canals). Some plans may also include orthodontic coverage.
What services are covered by vision insurance?
Vision insurance usually covers routine eye exams, prescription glasses, and contact lenses. Some plans may also offer discounts on corrective surgeries like LASIK.
What should I do if my dental or vision claim is denied?
If your claim is denied, you can appeal the decision by contacting your insurance provider and submitting necessary documentation. We’re here to help you understand the process and explore your options.
Supplemental
What is accident health insurance and how does it work?
Accident health insurance helps cover medical expenses from unexpected injuries. It pays for emergency treatment, hospital stays, and other related costs, providing financial peace of mind.
What is cancer and critical illness insurance?
Cancer and critical illness insurance provide a lump-sum cash payment if diagnosed with a serious illness like cancer, heart attack, or stroke. This money can help with medical bills, daily expenses, or other financial needs during recovery.
What is international travel health insurance, and why do I need it?
International travel health insurance covers medical emergencies while traveling outside the U.S. It ensures access to healthcare and helps pay for unexpected medical costs abroad.
